Intubated head injury — DipIMC MCQ

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HardRetrieval MedicineIntubated head injuryDipIMC

A ventilated head-injured patient needs transfer to a neurosurgical MTC. Blood pressure is labile and end-tidal carbon dioxide has not been documented. What is the most appropriate transport decision?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Optimise physiology and monitoring before transfer

Explanation lettering: E = shown as A · A = shown as B · B = shown as C · C = shown as D · D = shown as E

A is correct: Secondary brain injury during transfer is prevented by controlling oxygenation, ventilation and blood pressure. B is less suitable because it does not address the discriminator in the vignette; C is less suitable because it does not address the discriminator in the vignette; D is less suitable because it moves the patient before the decisive threat or destination issue is addressed; E is less suitable because it does not address the discriminator in the vignette. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.

Reference: JRCALC Guidelines; NICE Major Trauma Service Delivery NG40; ATACC